This A cross-sectional observational study included 48 individuals with hemiplegia after a stroke and 20 healthy participants for comparison. Demographic data and ultrasound evaluations were collected from all healthy subjects, while baseline assessments were done on 45 stroke patients within the first 48 hours of admission. These assessments looked at factors such as time since stroke, stroke type, affected side, feeding methods, lung infections, and ultrasound analysis of the diaphragm. The Fugl–Meyer Motor Function Assessment Scale (FMA Scale) and the Berg Balance Scale were also used. The ultrasound focused on diaphragm movement during quiet and deep breathing, thickness at the end of inhalation and exhalation, and the diaphragm's thickening ratio.

The main goal was to assess diaphragm function in hemiplegic patients post-stroke and its connection to limb movement and balance. Results showed that 46.67% of the 45 hemiplegic patients had diaphragm dysfunction during deep breathing. The paralyzed hemidiaphragm showed significant dysfunction with reduced movement during deep breathing (p < 0.05). The thickening ratio on the hemiplegic side was significantly lower compared to both healthy controls and the non-affected side (p < 0.05). The study highlights the need for breathing exercises in stroke rehabilitation to improve respiratory function and overall quality of life.

Reference: Lee, H.; Kang, T.; Kim, B. (2018). Effects of diaphragm and deep abdominal muscle exercise on walking and balance ability in patients
with hemiplegia due to stroke. J. Exerc. Rehabil. 14, 648–653.